Women's Care USA

  • Revenue Integrity Specialist

    Job Locations US-FL-Tampa
    Posted Date 1 month ago(12/10/2018 8:36 AM)
    Job ID
    2018-3760
    # of Openings
    1
    Category
    Billing/Revenue Cycle
  • Overview

    The Revenue Integrity Specialist is responsible for ensuring that payor contracted rates are entered into Practice Management systems timely and accurately. The position conducts ongoing analysis of charges and reimbursement. The Revenue Integrity Specialist identifies inaccurate payments and works with other members of the revenue cycle team to resolve them.

    Responsibilities

    • Performs timely and accurate entry of governmental and third party payor contracted rates into system.
    • Continual maintenance and monitoring of governmental and third party payor contracted rates.
    • Performs annual review of charge master and recommends updates.   
    • Prepares analysis related to the strategic pricing methodology of the system.
    • Performs analysis to ensure the organization is receiving accurate reimbursement from governmental and 3rd party payor contracts.
    • Performs regular reviews to identify inaccurate reimbursement, potential underpayments and lost revenue.
    • Communicates identified issues with appropriate department leaders and managed care staff to resolve concerns as appropriate.
    • Collaborates with revenue cycle team members and assists with resolving issues where variation is identified.
    • Communicates regularly with data analytics to create appropriate reports that are used for ongoing revenue analysis.

    Qualifications

    1. Knowledge of revenue cycle practices normally acquired through previous experience including understanding of multiple reimbursement systems.
    2. Experience with electronic medical record billing systems, knowledge of Ecw is preferred.
    3. Advanced skills in Microsoft applications such as Excel to create robust spreadsheets.
    4. Possesses problem solving and strong analytical skills necessary to develop and implement appropriate changes.
    5. Proficiency in Medical Practice Management Software Excel (Advanced) and other Microsoft applications.
    6. Excellent written, verbal, and interpersonal communication skills.
    7. Proficient in computer software and database skills.
    8. Ability to multi-task and work in a fast paced, high volume environment.

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